Surgical sponge stick



June 13, 1967 H. J. HElMLlCH 3,324,855

SURGICAL SPONGE STICK Filed Jan. 12, 1965 2 Sheets-Sheet 1 INVENTORHAM/F) J. f/E/MZ my ATTORNEYS June 13, 1967 H. J. HEIMLJCH 3,324,855

SURGICAL SPONGE STICK Filed Jan. 12, 1965 2 Sheets-Sheet 2' INVENTORWin/k) J. f/f/Ml/(I/ ATTORNEYS United States Patent 3,324,855 SURGICALSPONGE STICK Henry J. Heimlich, 851 Forest Ave., Rye, N.Y. 10580 FiledJan. 12, 1%5, Ser. No. 425,013 Claims. (Cl. 128269) This inventionrelates to an improved surgical instrument in the form of a surgicalsponge stick, capable of performing several functions during operatingprocedures.

Sponge sticks, as they are commonly referred to, are surgicalinstruments for use in prepping a patient (sterilizing an area on thebody where an incision is to be made) prior to an operation and formaintaining the operating field clear of fluid by controlling the bloodflow and general oozing associated therewith. Sponge sticks now in usecomprise expensive metal forceps that must be presterilized, havingclamping jaws into which is inserted a rectangular or square shapedsurgical sponge. The sponge is usually folded and loaded into theforceps by a nurse and then handed to the physician for use. The spongebecomes rapidly saturated and must be replaced immediately. Thispresents a serious problem. During an operation, a large number ofsponges of this type are necessary. The problem of sponge count presentsitself as each sponge used during an operation must be accounted for.Many devices and systems have been developed for reducing the danger ofsponge loss. Thus, sponge racks and the like have been utilized. Thedanger is a serious one and operations have been delayed considerablywhile searching for a lost sponge. An incorrect sponge count may prolonganaesthesia for the patient, bring about a need for X-rays in theoperating room if the sponge is left in the patient, generally reduceoperating efiiciency and endanger the patients life.

Even with the best of sponge material readily available, sponges tend tosaturate very quickly. They must be discarded and new ones immediatelysupplied, thus prolonging measurably the operating time. In addition,care must be exercised not to bring in contact any metal of the forcepswith organs when retracting, as there is a danger of inducing hematomaor lacerating an organ.

Prior to the operation, the area of incision on the body of the patientmust be sterilized. The prepping procedures involve a cumbersome seriesof steps resulting in loss of sterilizing solution and increase inoperating time.

My invention overcomes the aforementioned problems. It is an object ofmy invention to eliminate or reduce substantially the sponge countproblem and to increase the ability of the sponge material to retain itsabsorbency. In addition, sponge materials, such as polyurethane, whichare less absorbent than the normal gauze sponge and not practicallyusable, may now be utilized. The sponge material of my device may berejuvenated by simply placing it in saline solution to free any possibleclotting. It is a further object of my invention to reduce substantiallythe operative time'and thus decrease the danger to the patient. In thisconnection, the very sponging action of my device is faster and farsuperior to anything presently available. It is an additional object toeliminate the folding and loading time of sponges. My inventioneliminates the danger of hematoma or laceration of an organ when broughtin contact therewith, and accordingly, my sponge stick may be used as aretractor for overlying organs to keep the operative field unobstructedby these organs. The sponge portion itself may serve to aid in theretraction as suction is diffused throughout this portion, thuseliminating the direct application of suction to an organ. A furtheradvantage of my sponge stick is that it may be used for prepping apatient and in this connection, eliminates the need for a sterilecontainer of prep solution by "ice having the antiseptic solutionacompanying the sponge stick, thus greatly simplifying this procedure.

My invention presents the further advantage that one hand can be usedfor sponging as well as suctioning thereby freeing the surgeon and hisassistant for other duties. Furthermore, the operative field is keptcleaner at all times thereby increasing visibility. The operative fieldis kept clear of blood and other fluid, including saline, used to wetdown and wash out certain areas.

My invention contemplates the provision of an improved surgical spongestick comprising a hollow tubular handle made of a relatively rigidmaterial and having a first end with an opening adjacent thereto, asecond perforated end and a porous absorbent surgical sponge materialmounted on said handle in surrounding relationship with said perforatedend. The first end of the handle is formed so that it can be attached toa source of suction. In this regard, fluid, such as blood, may beaspirated through the surgical sponge and the tubular handle. The spongeis fixed to the tubular handle and the entire device may be for one timeuse. In addition, means such as a frangible cartridge containing anantiseptic solution may be placed within the hollow tubular handle.

Several modifications of the sponge stick and the manner of using thesame are described herein with references to the drawings in which:

FIG. 1 is a partially fragmentary view of one form of my invention witha portion of the sponge being cut away to show the mounting of thesponge on the handle;

FIG. 2 is a sectional view taken along the line 22 in the direction ofthe arrows as indicated in FIG. 1;

FIG. 3 is a cross-section of the sponge and handle portion associatedtherewith taken along the line 3-3 in the direction of the arrows asindicated in FIG. 2;

FIGS. 4 and 5 are fragmentary views of the second and third embodimentsof my invention in which fluid retain ing means are provided in thehandle;

FIG. 6 is a view somewhat similar to FIG. 1 showing the addition ofsupporting means for the surgical sponge;

FIG. 7 is a cross-section of the handle portion taken along the lines 77in the direction of the arrows as indicated in FIG. 6;

FIGS. 8, 9, 10 and 11 show in cross-section, alternate forms which thehandle of my invention may assume;

FIGS. 12 and 13 are views partly in section showing suction meansattached to the end of the sponge stick;

FIGS. 14 and 15 are views partly in section showing alternate means forattaching suction means to the sponge stick for swive-l movement;

FIG. 16 shows in the unassembled condition, the handle, sponge andsupporting structure of yet another embodiment of my invention;

FIG. 17 is a sectional view of the parts of FIG. 16 in their assembledrelationship; and

FIG. 18 is a sectional view of the sponge and handle in which theperforations of the handle provide communication between the sponge andthe interior of the handle on one side only of the sponge.

Each of the forms of sponge stick shown in the drawings comprises atubular handle having a first end with an opening adjacent thereto and asecond perforated end and a sponge portion made of a porous, absorbentmaterial which is secured to the handle in surrounding relationship tothe second perforated end.

Referring to the form of sponge stick shown in FIGS. 1, 2 and 3, thetubular handle is shown at 10, and it has a first open end portion 12and a second perforated end portion 14. The handle may be made of anysuitable material which is inert and unaffected by the body fluids,antiseptics, anaesthetics and other materials with which it is used andwith which it comes in contact. The material should also be such thatthe handle is relatively rigid, i.e.

it should be sufliciently rigid to support the sponge portion while inuse and also to serve as a retractor for the retraction of organs duringsurgical procedures. However, it should be yieldable or flexible enoughso that it can be squeezed or flexed sufficiently to rupture thefrangible container shown in FIG. 4 and release the contents thereof aswill be hereinafter explained. For this purpose, I have found thatplastic materials, such as polyethylene, polypropylene and polystyreneserve very satisfactorily. These materials present the further advantagethat they will not cause hematoma, nor laceration of overlying organs inthe operative field when in contact therewith.

In the form shown in FIGS. 1-3, the second perforated end of the tubularhandle is non-circular in configuration, i.e. it is partially flattenedas shown. The size of this flattened portion may be varied to lendadditional support to the sponge. The perforations are indicated by thenumeral 16 and the number and arrangement thereof may be varied.

In the form of device illustrated in FIGS. 1-3, perforations areprovided on both flattened sides and also on both of the narrow sides,as shown. Thus, communication is provided between all portions of thesurrounding sponge and the interior of the tubular handle.

As previously indicated, the sponge portion 18 is attached to thetubular handle in surrounding relationship to the perforated end. Thesponge portion may be made of any suitable porous, absorbent materialwhich is inert and unaffected by the body fluids, antiseptics,anaesthetics and other fluids with which it is used and with which itcomes in contact. Thus, it may be made of gauze of the type used inconventional surgical sponges or it may be made of a suitableelastomeric synthetic sponge material, such as polyurethane,polyethylene or polypropylene foam.

The sponge portion 18 is attached to the handle 10 in surroundingrelationship to the perforated end. Where gauze is used for the spongeportion, the successive wrappings or layers of gauze may be stitchedtogether or, as in the case of the surgical sponges presently used, maysimply be held together by the fibers or lint of the gauze. A spongeportion made of gauze may be suitably secured to the perforated end ofthe tubular handle as shown as by stitching or by a suitable adhesive,which is inert t and unaffected by the fluids which come in contacttherewith. A suitable adhesive for this purpose is silicone adhesive.Thus, the outer surface of the perforated end of the handle may becoated with the liquid silicone adhesive and the gauze sponge portionapplied thereto.

Where the sponge portion is made of an open cell plastic foam material,the sponge portion may be held in place by friction or by a suitableadhesive of the type indicated above. 7

In using my improved sponge stick as a surgical sponge, the openingadjacent the first end of the handle is connected to a suitable sourceof suction, such as a vacuum pump, vacuum chamber or the like. In FIGS.12 to 15, I have shown various illustrative coupling structures forconnecting the open end 12 of the tubular handle to a vacuum line. Thus,in FIG. 12, I have shown a coupling sleeve 20 which couples the end ofthe tubular handle to vacuum line 22. The coupling sleeve 20 has a tightfrictional fit with both the handle and the vacuum line. In thisconnection, both the coupling sleeve and the vacuum line should be madeof a material inert to and unaffected by the fluids which come incontact therewith.

In FIG. 13, the open end of the tubular handle is fitted with a tubularplug 24, having an enlarged sleeve portion 26 which engages over thevacuum line 22. The plug portion has a tight frictional fit with theinner wall of the tubular handle and the sleeve portion 26 has a tightfrictional fit with the outer surface of the vacuum line.

In FIGS. 14 and 15, I have shown couplings for providing a swivelconnection to both the opening at the first end of the tubular handleand the vacuum line. Thus, in FIG. 14, I have shown a coupling sleeve 28tightly embracing the outer end of the tubular handle and having areduced outer end portion 30 terminating in an exterior lip portion 31.The vacuum line 32 is provided with a restricted collar portion 34projecting therefrom at right angles and which engages the reduced end30 of the coupling member so that it can rotate with respect thereto andwill be held in place by the outer lip portion.

In FIG. 15, the vacuum line 36 is provided with a laterally projectingcollar portion 38, having a plurality of circumferential interior ribs40 which frictionally engage the exterior surface of the first end ofthe tubular handle to provide a sealing fit while, at the same time,permitting relative swivel or rotary motion. To help provide a sealingfit between the vacuum line and the tubular handle, I also preferablyprovide shoulder portions 42 in the interior of the vacuum line inengagement with the outer end of the handle.

During surgical procedures, such as surgical operations, the first endof the tubular handle is connected, as indicated, to a source ofsuction. The surgeon or assistant can then grasp the handle portion ofthe sponge stick in one hand, leaving his other hand free. The spongeportion is applied to appropriate areas to remove blood or other fluidand thereby maintain the operative area clean and visible at all times.The blood or other fluid is removed both by the aspirating action and bythe absorption characteristics of the sponge portion. Most of the fluidswill be aspirated through the sponge and perforations and thence,through the handle portion to a receptacle adjacent the source ofvacuum. In this connection, it will be appreciated that the spongeperforms afiltering action so as to prevent solid particles fromclogging the perforations in the handle portion. In addition, theabsorbency of the sponge material is increased measurably with theemployment of suction. Thus, the sponge may, if it has solid materialadhering to it to obstruct the fiow of fluids therethrough (which doesnot easily occur) be rejuvenated simply by dipping it in salinesolution.

During the surgical procedure, the sponge stick may also be used as aretractor for retracting overlying organs in the operative field. Byengaging the sponge portion with the overlying organ, at no time dosharp metal edges come in contact with tissue to cause hematoma orlaceration.

For general use, it is desirable to have perforations on all sides ofthe second end of the handle so as to provide communication between allportions of the sponge and the source of suction. However, for certainpurposes. it might be desirable to have the suction operating throughonly one portion of the sponge. To accomplish this result, perforationsmay be formed on one side only at the perforated end of the tubularhandle. Alternatively, the perforated end of the handle may beperforated on all sides but may be provided with an impervious plasticshield 44 between the sponge portion and the perforated end of thehandle throughout the area where it is desired to eliminate the suction,as shown in FIG. 18. The impervious shield 44 may be made of a suitableflexible plastic material which is unaffected by the fluids which comein contact therewith as, for instance, polyethylene or polypropylene. Itmay be secured in place by an adhesive of the type indicated above.

Under certain circumstances, it may be desirable to maintain theconfiguration of the sponge portion, as for instance, when it is used asa retractor as well as a sponge. For this purpose, suitable supportmeans or frame work may be provided in the interior portion of thesponge portion in engagement therewith. Thus, as shown in FIG. 6, asupport in the form of a pair of U-shaped filaments 46 may be embeddedin the sponge portion on opposite sides of the perforated end portion inengagement therewith. The supports may be made of metal wire or asuitable plastic material unaffected by the fluids which come in contacttherewith as, for instance, stainless steel, polyethylene orpolystyrene. The end portions of the supports may be suitably secured tothe sides of the perforated end portion of the handle by being embeddedtherein or cemented thereto.

An alternate form of supported configuration for the sponge portion isshown in FIGS. 16 and 17. In this form of device, the sponge portion isformed of two sections 18' which are secured on opposite sides of theperforated end portion of the tubular handle and are held in the desiredconfiguration by the complementary support means 48 and 49 disposed onopposite sides of the sponge portion. The support means 48 and 49 may bemade of plastic filaments inert to and unaffected by the fluids whichcome in contact therewith, of the type indicated above. Where the spongeportion is of rectangular configuration the support means are preferablyof rectangular configuration but slightly smaller in size than thesponge portion. The support member 48 is provided with projecting studportions 50 and the support member 49 is formed with complementaryreceptacle portions 51 for receiving the stud portions.

In assembling the structure in FIGS. 16 and 17, the two sections of thesponge portion 18' are arranged on opposite sides of the perforated endof the handle and the support members 48 and 49 are arranged inalignment with each other on the opposite surfaces of the two spongeportions and pressed toward each other. The receptacle members 51 andstuds 50 penetrate through the sponge material and the studs engage inthe receptacle members. The studs may be retained in the receptacle byfriction or by a suitable bonding agent of the type indicated above.When thus assembled, the sponge portion will be maintained insubstantially its original configuration by support members 43 and 49.

The cross-sectional shape of the handle portion may conveniently becircular as shown in FIG. 7. However, various other configurations ofhandle portion may be used to facilitate gripping and to providestrength thereto, as shown at a, 10b, 10c and 10d in FIGS. 8 to 11. Inaddition, the shape and size may be varied to provide for sponge stickswhich may be used as retractors for large organs, such as theintestines.

As previously indicated, my improved sponge sticks may be used inprepping a patient prior to an operation. When used for this purpose, Iprefer to provide a suitable antiseptic, sterilizing or prep solution orliquid in the handle portion. In this connection, the liquid or solutionmay be retained in the tubular handle or associated therewith in anysuitable fashion so that it may be readily released to the spongeportion when desired.

Illustrative embodiments of the sponge stick having liquids or solutionsof this type in the tubular handle are shown in FIGS. 4 and 5.

In FIG. 4, the liquid or solution is contained in a frangible cartridge52 disposed in the handle and retained therein by means of a suitablestop 54 secured inside the handle adjacent the first open end thereof.The stop may be made of a plastic material similar to the handle and maybe cemented in place. The cartridge or ampoule 52 may be made of a thinfrangible plastic material which will break when the handle is squeezedor when it is flexed through the area Where the ampoule is disposed. Forthis purpose, the ampoule may be made of a thin brittle polystyrene,polypropylene or other suitable material.

In the form of device shown in FIG. 5, I provide the handle with a smalldimple 56 which serves as a stop or positioner for a diaphragm 58.Spaced from the diaphragm 58 toward the first end portion of the handleis a smaller piston member 60 which may be operated by a plunger 62.Initially, the solution or liquid is contained inside the handle betweenthe diaphragm 58 and the piston 60. Both the diaphragm and the pistonmay be made of a suitable plastic material inert to the materialcontained in the handle such as polyethylene or polypropylene. Also,both the diaphragm and piston have frictional 6 sealing engagement withthe interior of the handle portion.

When it is desired to use the sponge sticks shown in FIGS. 4 and 5, inprepping a patient prior to an operation, the antiseptic or prepsolution is first released into the sponge portion. In the form shown inFIG. 4, this is accomplished by breaking the frangible ampoule bysqueezing or flexing the handle. In the form shown in FIG. 5, this isaccomplished by shifting the plunger 62 to the left so as to cause thepiston to increase the pressure of the liquid sufliciently to open orrelease diaphragm 58. In both instances, the liquid will flow downwardlyto the perforated end of the handle and thence, through the perforationsinto the sponge. The antiseptic liquid is then swabbed over the surfaceof the skin where the incision is to be made.

In the several forms of my invention, the specific shape orconfiguration of the sponge portion may be varied. At the present time,surgical sponges are generally of rectangular configuration and thesponge portions of my sponge sticks may be of similar configuration.However, it should be understood that the sponge portions may be ofcircular or any other geometric configuration.

In addition, the specific shape or configuration of the handle 10 mayalso be varied. It should be long enough to be conveniently gripped bythe hand and sufficiently long to eliminate or substantially reduce thechance of the sponge stick being left in the operative area whenclosing.

It will thus be seen that I have provided an improved sponge stick whichmay be used either for prepping a patient prior to an operation or formaintaining the operable field clear of fluid by controlling the bloodflow and general oozing associated therewith.

Modifications may be made in the illustrated and described embodimentsof my invention, as for instance, by varying the specific shape orconfiguration of the different parts or by varying the means used forretaining the parts in assembled relationship or by varying thestructure for retaining the antiseptic or prep solution in the handle.

I claim:

1. A device to be used as a surgical sponge for removing excess fluidsduring surgical procedures comprising: a hollow tubular handle made ofrelatively rigid plastic material having a first end with an openingadjacent thereto and a perforated second end with a partially flattenedconfiguration, porous absorbent surgical sponge material mounted on saidsponge handle in surrounding relationship to said partially flattenedperforated end, said first end of the handle having means for connectingthe opening of the first end of the tubular handle to a source ofsuction so that fluid may be aspirated through the sponge material andhandle.

2. A device to be used as a surgical sponge for removing excess fluidsduring surgical procedures as set forth in claim 1 in which theperforations at the perforated end of the handle provide communicationbetween the sponge and the interior of the handle on one side only ofthe device whereby aspiration will take place through the spongematerial on said one side only.

3. An improved surgical sponge stick in accordance with claim 1 whereina hollow tubular handle made of a relatively rigid material and having afirst end with an opening adjacent thereto and a second perforated end,porous absorbent surgical sponge material mounted on said handle insurrounding relationship with said perforated end and means are withinsaid tubular handle for releasably retaining a fluid therein.

4. An improved surgical sponge stick as set forth in claim 3 in whichsaid fluid retaining means comprises a frangible cartridge and in whicha stop is provided at the first end of said tubular handle to retain thecartridge within said tubular handle.

7 V v 8 5. An improved surgical sponge stick as set forth in ReferencesCited claim 3 in which said fluid retaining means comprises 21 UNITEDSTATES PATENTS diaphragm positioned in the tubular handle relativelyadjacent the perforated end, and also piston means posi- 1853238 4/1932stilelds 128*269 2,294,186 8/1942 Klrschbaurn 128269 tioned in thehandle and spaced from said diaphragm 5 2171070 11/1956 S 128 231 towardsaid first end of the handle whereby the diaphragm axon 3,179,108 4/1965Boch et al 128-269 can be opened by shifting the piston toward thediaphragm to increase the fluid pressure. ADELE M. EAGER, PrimaryExaminer.

1. A DEVICE TO BE USED AS A SURGICAL SPONGE FOR REMOVING EXCESS FLUIDSDURING SURGICAL PROCEDURES COMPRISING: A HOLLOW TUBULAR HANDLE MADE OFRELATIVELY RIGID PLASTIC MATERIAL HAVING A FIRST END WITH AN OPENINGADJACENT THERETO AND A PERFORATED SECOND END WITH A PARTIALLY FLATTENEDCONFIGURATION, POROUS ABSORBENT SURGICAL SPONGE MATERIAL MOUNTED ON SAIDSPONGE HANDLE IN SURROUNDING RELATIONSHIP TO SAID PARTIALLY FLATTENEDPERFORATED END, SAID FIRST END OF THE HANDLE HAVING MEANS FOR CONNECTINGTHE OPENING OF THE FIRST END OF THE TUBULAR HANDLE TO A SOURCE OFSUCTION SO THAT FLUID MAY BE ASPIRATED THROUGH THE SPONGE MATERIAL ANDHANDLE.